In the midst of the pandemic, an epidemic of violence has gripped Hampton Roads and beyond

Norfolk — During Thanksgiving week, Ebony Pope lay in a hospital bed in Norfolk, wondering how she would recover and whether she’d have lifelong side effects.

It wasn’t COVID-19. But Pope, 37, believes the coronavirus could have played a role in what happened.

On Nov. 18, 2020, she and her mother, 18-year-old daughter and baby grandson visited a friend in the Cradock section of Portsmouth. When they were ready to leave, Pope drove them home. She returned on her own to visit the friend without them — a blessing in hindsight, she said.

As she sat on the couch, gunfire suddenly blasted into the home. She was shot in the buttocks as she dived to the floor. The bullet hit her colon in two places and damaged her left kidney, which had to be removed in emergency surgery.

Eight months earlier, she lost her son in a car accident. Now she was face-to-face with her own mortality.

Then, bill collectors started calling.

“It got stressful because I’m not working, I got injured, there’s a pandemic going on, you’re calling every other day, asking are we going to get this in, can family do this or do that, do you have a support system?” said Pope, now living in a hotel and working at a Walmart. “It’s almost like you’ve got to give them a story for them to help you.”

While the coronavirus has ravaged communities over the past year, health care workers say another epidemic has been raging in the backdrop. Doctors at Sentara Norfolk General Hospital, the region’s level 1 adult trauma center, pulled out more bullets, stitched more stab wounds and treated more assault victims than in recent history.

Pope is just one victim of the violence that has swept the nation and Hampton Roads during the pandemic. In 2020, a year mostly spent in lockdown, the hospital saw 38% more violence-related trauma patients than the year before. Patients with gunshot wounds jumped from 328 to 466. The death toll from violent injuries also climbed, from 28 in 2019 to 49, nearly doubling.

And despite the country beginning to return to life as usual, the violence doesn’t appear to be letting up. In the first four months this year, the hospital encountered 153 gunshot patients, 27 with stab wounds and 46 victims of assault — about 30% of the caseload the team handled in all of 2020.

The vast majority of those patients were Black men in their 20s.

“We did not anticipate this at all,” said Dr. Jay Collins, chief of trauma at Norfolk General and a surgery professor at Eastern Virginia Medical School. “In the last year, we’ve had a huge jump, and I personally don’t think it’s just COVID. It seems like we’re seeing more assault-type weapons.”

Violence has devastated communities for ages, but hospitals and medical professionals have recently begun to see the crisis as more than a social problem; it’s a public health issue. The terminology has changed, with many doctors referring to it as a disease.

‘Idle hands’

But this “disease” is different, as hospital data, which only accounts for the cases that reach the emergency room, can’t capture the full picture. Many people die on the street or skip medical care.

There were 21 homicides in Norfolk this year through May, two more than in the first five months of last year. But shootings — which Police Chief Larry Boone has described as the “tell-tale story” of violence within a city — have skyrocketed. There were 98 non-fatal shootings through the end of May, a 75% jump over last year, according to data from the department.

Norfolk is not alone.

The number of murders and aggravated assaults — which includes shootings — spiked across the state, according to Virginia State Police. There were 528 homicides in Virginia last year, more than a 23% rise over 2019. And there were roughly 12,330 aggravated assaults in 2020, about an 11% bump from the year before.

And communities must now endure the post-Memorial Day summer months, when violent crime tends to increase.

It’s too soon to have answers about what’s driving the new surge, said Christina Mancini, professor and criminologist at Virginia Commonwealth University.

There’s also no precedent for a pandemic and how that influences violence, she added. Violent crime tends to be committed by younger men and boys. Because of the pandemic’s impact on schools and social activities, many have had fewer things to do.

Combine lost jobs, free time, bills to pay and a whole lot of anxiety, that can lead to trouble, Mancini said.

“My grandma always said the ‘idle hands’ thing,” she said. “People just went haywire.”

Researchers are still studying what caused the massive nationwide drop in crime starting three decades ago, so criminologists likely will puzzle over the recent uptick for a while. The pandemic, for instance, hasn’t been all bad when it comes to crime, Mancini said. Murders and shootings went up, but rapes, robberies and burglaries have plummeted. In Virginia, they dropped to their lowest levels in at least five years, according to state police.

From a surgeon’s perspective, it’s not just a volume issue — violent injuries are getting harder to treat. Assault weapons, used in more cases Collins has handled, spit out ammunition at high velocity with more kinetic energy. Some bullets are designed to explode into pieces upon impact.

“It’s in some ways like getting shot with several different bullets, even though you were only shot with one,” Collins said.

The unseen injury

For Pope, her nine-day hospital stint wasn’t the cure that got her back on her feet. Like for so many gunshot patients, there were more consequences.

Some survive but are paralyzed — forever reliant on wheelchairs, ventilators or colostomies, the surgical openings in the abdomen created to bypass a damaged colon.

Pope was perhaps one of the lucky ones. Though she doesn’t have severe long-term complications other than some nerve damage and pain with digestion, she had to return to the hospital two weeks later. The bullet lodged in her chest hadn’t been removed because of its depth, and created an infection. That required another emergency surgery.

The bullet is now gone. What will stay is the psychological damage — the unseen injury that can last a lifetime, social workers say.

If Pope visits someone’s house, she doesn’t stand near windows. She avoids crowds. She carries on, but not as the woman before the shooting. No one has been charged in the crime, she said.

“It changed me,” Pope said. “You can’t trust your surroundings.”

Health care workers say approaching gun violence as a disease comes with challenges. If a patient has a heart attack, a doctor can advise him to lessen his risk of another by losing weight, monitoring cholesterol, eating right and stopping smoking.

But what does a doctor say after patching bullet holes?

Those former patients often end up back in the environment where they were hurt. Medical school trains surgeons on how to stop hemorrhaging and stitch wounds. It doesn’t prepare them for telling survivors of violence how to keep from getting shot again.

“A lot of these are young African American males,” Collins said. “I’m an older, white, successful person, and we probably can’t be any more different. I’m sure they look at me like, ‘You have no idea what my life’s like’ — which is probably true.”

That’s when Foresight, a relatively new hospital-based violence intervention program, steps in at Norfolk General. With funding from the Virginia Hospital & Healthcare Association’s foundation, victims are paired with case managers to connect them to community resources. They receive information about victim rights, victim advocacy, assistance in applying for public benefits, crisis intervention, emergency financial assistance, transportation and housing services.

Over the past year, Sentara has received $317,000 to support its program. Starting in July, grants will go to Norfolk General, along with Children’s Hospital of The King’s Daughters, Riverside Regional Medical Center and VCU Health.

Between April 2020 and March 2021, the year of COVID-19, the money has paid for services to help 1,700 patients at the participating Virginia hospitals, according to the hospital association. A small fraction — only 1.4% of the people receiving the services — have come back with violent injuries.

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As a survivor of gun violence, it’s difficult for Pope to think of the issue medically — that what happened to her could qualify as a disease. She looks at her community: not enough recreation centers, after-school programs and jobs.

There are people, still rattled by the pandemic, afraid to go to work.

“No one has nothing to do to occupy their time,” she said. “There’s nothing productive going on.”

That word, “disease,” conjures a different meaning for her — something more inevitable and beyond human control.

“A disease is something that you can’t get rid of,” she said. “These are issues within the community as a whole.”

Elisha Sauers, 757-839-4754, elisha.sauers@pilotonline.com

Jonathan Edwards, 757-739-7180, jonathan.edwards@pilotonline.com